WHO (Europe) - World Health Organization Regional Office for Europe=

In 2008, the WHO Regional Office for =
Europe together with the European Commission and WHO headquarters, sta=
rted to collect data on alcohol consumption, alcohol related harm, and resp=
onses data issued for a global/regional database and available to=
the public since spring 2010 (http://apps.who.int/globalatlas/default.asp). The data was used for the European Status report on alc=
ohol and health 2010, which was published in January 2011.

=20

Ongoing methodological work:<=
/strong>

=20

=E2=80=A2 Data collection from 53 Eur=
opean Member States;=
=E2=80=A2 A system for online data entry which will be used for a new =
data collection in 2012;=
=E2=80=A2 Entering data into an SPSS file.

=20

Priority objective of methodo=
logical work:

=20

=E2=80=A2 A shared database at WHO he=
adquarters with a platform for each European Region as well as for EU =
Member States only, is improved at regular intervals;=E2=80=A2 Review and improvement of data quality=
with a special focus on alcohol consumption by reconciling a ran=
ge of different sources of data;=E2=80=A2 Improvement of the international coordination of the data c=
ollection in order to secure that data for one country are the same in=
different international sources.

=20

New activities:

=20

=E2=80=A2 Preparation of a European r=
eport using data collected for EU Member States during 2011 will be publish=
ed in March 2012.=E2=80=A2=
Preparation of a European Status report on alcohol and health will be publ=
ished during 2013. Meetings planned in the next two years.=E2=80=A2 Conference to launch a new public=
ation: Alcohol in Europe=
to take place on 27 March 2012.<=
/span>

This database contains data gathered throu=
gh surveillance, prevention and control activities on communicable diseases=
- such as tuberculosis, HIV/AIDS and sexually transmitted infections, and =
malaria - and data on immunization coverage in countries. It offers informa=
tion on recent outbreaks in Europe and some other textual information. The =
database permits a detailed review and situation assessment of the main inf=
ectious diseases in the WHO European Region and also offers some data =
at the subnational level.

=E2=80=A2 Annual collection and disseminat=
ion of data on non-vaccine preventable infectious diseases, including zoono=
tic, vector-borne, blood-borne and water related, through the annual commun=
icable disease reporting forms and maintained in the CISID database;=

=20

=E2=80=A2 Annual collection and disseminat=
ion of epidemiological data on the following sexually transmitted infection=
s (STIs): Syphilis (total, early, late and congenital), Gonorrhea, Chlamydi=
a, Herpes simplex and HPV as well as viral hepatitis and HIV/ hepatitis co-=
infection. Data are collected through the WHO Communicable Disease Annual R=
eporting Form and maintained in the (CISID) database;

=20

=E2=80=A2 Enhanced surveillance of =
HIV/AIDS conducted jointly by the WHO Regional Office for Europe and the Eu=
ropean Centre for Disease Prevention and Control (ECDC) in the 53 WHO Europ=
ean Member States since January 2008. Dissemination of data in an annual WH=
O/ECDC HIV/AIDS surveillance in Europe report (available at http://www.euro.who.int/a=
ids) and through the centralized information system for infectious dise=
ases (CISID): http://data.euro.who.int/cisid/;

=E2=80=A2 Development of an online data en=
try tool for rubella and Congenital Rubella Syndrome through CISID;<=
br /> =E2=80=A2 Refinement of electronic data=
transfer protocols between ECDC and WHO databases;=E2=80=A2 Improvement of automated uploading capabiliti=
es in countries that are reporting surveillance data to CISID.

Health Accounts

=20

Purpose:

=20

WHO Europe's work on health systems financing includes efforts to produc=
e reliable, internationally comparable and transparent estimates of health =
expenditures for each country in the Region, using a common international s=
tandard (the International Classification for Health Accounts). Estimates a=
re produced in a consultative process with technical specialists in all Mem=
ber States and partner agencies. The work results in aggregate health expen=
diture estimates being available online in the WHO Europe Health for All da=
tabase.

=20

Ongoing methodological work:

=20

The new System of Health Accounts (SHA) 2011, a global standard for defi=
ning and classifying financial resources for health, introduces major chang=
es to the reporting standards, taking into account countries' specificities=
and differences in analytical needs. The work is led jointly by WHO, OECD =
and Eurostat.

=20

=E2=80=A2 Training material is currently developed by Abt Associates to =
facilitate the transition from National Health Accounts (NHA) and SHA to SH=
A 2011. =E2=80=A2 Mapping between NHA and SHA will be developed by th=
e Eurasian NHA network to facilitate the consistency of the process in the =
CIS countries.

=20

Priority objective of methodological work:

=20

WHO/Europe has established a validation process of all health expenditur=
e data published in the Health for All Database, the WHO World Health Stati=
stics and the WHO WHOSIS database. The validation consists of an informal n=
etwork of health accounting and/or health financing experts in the Region w=
ith whom preliminary WHO estimates are shared and this same network is also=
invited to provide comments and alternative estimates.

=20

=E2=80=A2 Facilitating the transition from SHA and NHA to SHA 2011 by de=
veloping producers' guidelines and trainings. =E2=80=A2 Ensuring the =
continuity of the existing NHA data series and mapping the data according t=
o the new standard. =E2=80=A2 Some statistical data referred to on ph=
armaceuticals are included in the European Health for All database (mostly =
types of expenditure data on medicines) and is coordinated with the Nationa=
l Health Accounts as well.

=20

New activities:

=20

=E2=80=A2 Training in the WHO Regional Office for Europe is planned to b=
e delivered as an addition to an extended OECD annual meeting for health ex=
perts in October. =E2=80=A2 The training on SHA 2011 which is set up =
as an implementation year for SHA 2011 is likely to continue until 2014. =E2=80=A2 Training for the CIS countries will be provided at the Eurasi=
an NHA annual meeting organized by WHO Regional Office for Europe.

=20

Health Statistics<=
/span>

=20

Purpose:

=20

WHO Europe provides twice yearly updated information for the assessment =
and monitoring of the health situation and of trends in health and health c=
are in countries of the European Region in order to provide support for dec=
ision-making and for the formulation of public health policies and programs=
including the assessment of their effectiveness. In this regard, the WHO R=
egional Office for Europe collects, reviews the quality and maintains over =
600 indicators from various health dimensions, with diverse levels of detai=
l in different databases.

=E2=80=A2 Preparation of the 2012 European Health Report. In addition to=
the basic analyses of situation and trends, it will have emphases on healt=
h and well-being of the population of the Region. It also serves as a prime=
instrument for dissemination of statistical findings from the Region. This=
year the report will also provide a baseline for health targets indicators=
set up in the new WHO Health 2020 policy for Europe.

=20

Priority objective of methodological work:

=20

=E2=80=A2 Design of an integrated system of statistical databases mainta=
ined by specific WHO Europe technical programs available to external users =
via uniform interfaces;

=20

=E2=80=A2 Review and improve data quality of WHO Europe data sources at =
different levels and establish mechanisms and tools to facilitate the proce=
ss. Also implement data quality assessments and an improvement strategy for=
WHO and country health data collections;

=20

=E2=80=A2 Improve the coordination and comparability of international da=
ta collection in collaboration with other international agencies (primarily=
OECD and EC/EUROSTAT). Work on the coordination of health data collection =
and harmonization of health indicators in the European Region is ongoing. F=
ollowing the national health accounts example, a joint OECD/EUROSTAT/WHO Eu=
rope data collection on non-expenditure health indicators started in 2010 a=
nd will continue in 2012, further expanding its indicators and the number o=
f countries participating (to include non-EU/OECD ones).

=20

=E2=80=A2 WHO Europe developed=
jointly with the European Commission, DG-Sanco, an integrated health infor=
mation system for the display and analysis of indicators on socioeconomic s=
ituation, health, and health care resources at regional level (so-called NU=
TS2-level). This web-based tool brings together data allowing assessments o=
f regional inequalities across Europe.=
span> Three types of interactive atlases=
address different questions and display data, accordingly:Regional comparison atlas, Correlation map atlas=
and Atlases of social inequalities. They areavailable at:http://www.euro.who.int/en/what-we-do/data-and-evidence/equity-in-h=
ealth/interactive-atlases. A new developmental stage on the atlases will continue in 2012, emphasizing t=
hree aspects: inclusion of time series capabilities, environmental indicato=
rs, and organization by thematic health topics.

=20

=E2=80=A2 A new health policy framewo=
rk (Health 2020) for Europe is being developed by the WHO Regional Office f=
or Europe for its Member States. Emphasis will be placed on six areas: gove=
rnance for health; inequities in health; healthy people; the environment (i=
ncluding risk factors and the determinants of health); the burden of diseas=
e and health system performance. Monitoring progress towards targets in the=
se areas will be an integral part of the process. Definition of targets and=
indicators is currently under way, with contributions from different stake=
holders. A special element to be included is the assessment and moni=
toring of health and well-being, this one requiring additional methodologic=
al work, also on its way.

=20

=E2=80=A2 Additional areas of HEN's methodological work will include the=
following: Grading the strength of policy considerations; developing metho=
ds of combining evidence from different types of studies and other informat=
ion; and refining methods for collecting questions and developing dialogue =
with policy-makers.

=20

Nutrition and physical acti=
vity

=20

Purpose:

=20

In 2005 the WHO Regional Office for E=
urope started to collect data on the prevalence of overweight and obesity i=
n all population groups in preparation for the European Ministerial Confere=
nce on Counteracting Obesity (15-17 November 2006, Istanbul).At the Conference, Member States approved the =
European Charter on Counteracting Obesity, which lists goals, guiding princ=
iples and a framework for action. In September 2007, the WHO Regional Commi=
ttee for Europe endorsed the WHO European Action Plan for Food and Nutritio=
n Policy 2007-2012, which calls on Member States to develop and implement f=
ood and nutrition policies and translates the principles and framework prov=
ided by the Charter into specific action packages and monitoring mechanisms=
.

=20

To follow up and ensure implementation of the Charter and the Action Pla=
n, the WHO Regional Office for Europe collects information within the follo=
wing areas:

This data collection is being carried out in close collaboration with th=
e Directorate-General for Health and Consumers of the European Commission.<=
/p>=20

A database was developed to facilitate processing of the information ide=
ntified, entitled the "Database on Nutrition, Obesity and Physical Act=
ivity (NOPA)". As a monitoring tool=
, the NOPA database can stimulate policy-makers to identify gaps and needs =
in data collection and policy development, or show progress in their fight =
against obesity.

=20

Ongoing methodological work:

=20

=E2=80=A2 Annual collection and processing of national and subnational d=
ata on the prevalence and trends of overweight and obesity, physical inacti=
vity, food consumption and nutrient intake in all population groups (childr=
en, adolescents and adults) from the 53 Member States of the WHO European R=
egion; =E2=80=A2 Annual collection and processing of national policie=
s on nutrition, obesity and physical activity promotion; =E2=80=A2 Tw=
o rounds of data collections took place (in 2007/2008 and 2009/2010) as par=
t of the WHO European Childhood Obesity Surveillance Initiative that aims t=
o routinely monitor policy response to the emerging obesity epidemic. Body =
weight and body height as well as dietary and physical activity patterns ha=
ve been measured among primary schoolchildren aged 6-9 years. A third round=
will take place during the school year 2012/2013.

=20

Priority objective of methodological work:

=20

=E2=80=A2 Calculation of intercountry comparable estimates of the preval=
ence of overweight/obesity among 6-9-year-old children as a result of the t=
wo COSI data collection rounds.

=20

Meetings in 2012:

=20

=E2=80=A2 Sixth meeting of the principal investigators of the participat=
ing countries in the WHO European Childhood Obesity Surveillance Initiative=
(Oslo, Norway; 15-16 November 2012). <=
br class=3D"atl-forced-newline" />

=20

Social determinants, gender=
and inequalities

=20

Purpose:

=20

To strengthen the capacity of WHO Member States to systematically use an=
alyses of social & economic determinants and health inequalities to inf=
orm the development, implementation, monitoring and evaluation of health po=
licies and programmes. This includes strengthening the capacity of the WHO =
Regional Office for Europe and its Member States to: (a) generate and or ma=
ke use of existing data disaggregated by sex and age and cross link with av=
ailable data on social and economic determinants (place of residence, level=
of education, income, employment status etc); and (b) analyse the findings=
with other forms of knowledge to better inform policy development, impleme=
ntation, monitoring and evaluation.

=20

Ongoing methodological work:

=20

=E2=80=A2 Working with WHO technical units to develop a minimum standard=
s approach for ensuring collection and use of disaggregated and cross linke=
d data in all key strategy and policy documents. For example, work with WHO=
NCD area regarding minimum set of indicators for integrating social determ=
inants and equity into the set of targets and indicators to be developed as=
part of the NCD surveillance, monitoring and evaluation.

=20

=E2=80=A2 Ongoing delivery of an overall capacity building programme for=
systematic use of disaggregated data and diverse methods and approaches fo=
r assessing data and knowledge on gender, other social determinants and equ=
ity. This will include targeted technical assistance for the development of=
country-specific products such as health inequalities profile or an SDH re=
port; and in-country capacity building workshops (as requested and appropri=
ate) on use of specific tools and approaches such as equity focused Health =
Impact Assessment and or linked to ICP/multicountry work as part of the SDH=
/Equity Solutions lab.

=20

Priority objectives beyond 2012:

=20

Same as ongoing for 2012 and activities for 2012 e.g. manual on collecti=
on and use of evidence for action on social determinants and health inequal=
ities (see below).

=20

New work to be undertaken in 2012:

=20

=E2=80=A2 Development of a manual for all 53 Member States on collecting=
and assessing evidence on gender, other social determinants and equity for=
development of evidence informed policy. It will be based on, adapt and ad=
vance the findings from the final report and guide from the global Measurem=
ent & Evidence knowledge network with regard to developing policy optio=
ns for tackling the social determinants of health inequalities. =E2=
=80=A2 Development and delivery of an intensive 5-day training and capacity=
building programme on the systematic use of disaggregated data and div=
erse methods and approachesfor assessing data and knowledge on gender,=
social determinants and equity for informing the development, implementati=
on, monitoring and or evaluation of health policies and programmes for impr=
oved health and gender equity.

=20

Meetings for 2012:

=20

=E2=80=A2 Meetings of advisory and expert group to be established for de=
velopment of guidance and capacity building programme. =E2=80=A2 Work=
shop with Member States to deliver intensive 5 day capacity building and tr=
aining programme.

=20

Gender statistics<=
/span>

=20

Purpose:

=20

Strengthen WHO's capacity to provide reliable information on gender ineq=
ualities in health to inform policies and programmes in countries.

=20

Ongoing methodological work:

=20

=E2=80=A2 To revise the main WHO databases from a gender perspective ide=
ntifying gaps and making recommendations for improvement. =E2=80=A2 S=
election and review of key gender-sensitive indicators. This builds upon th=
e work carried out at the global level and the recommendations from the WHO=
consultation on Gender- Sensitive health indicators to support country mon=
itoring, Washington 2010.

=20

New activities:

=20

=E2=80=A2 Gender analysis of the WHO databases. This work started in Jan=
uary 2012 and will continue throughout the year. =E2=80=A2 Collaborat=
ion with the European Institute for Gender Equality on the development of a=
satellite index on gender equality in health. =E2=80=A2 Dev=
elopment of a Solid Facts on gender inequities and health in the European R=
egion. This will be based on the analysi=
s of the existing WHO data and the findings of the SDH Review.=
=E2=80=A2 Development of gender sensiti=
ve indicators to monitor well-being.

The purpose is to provide data, infor=
mation and analytical synthesis on the interrelationships between environme=
nt and public health issues (EH). This process allows monitoring of EH tren=
ds. Progress with regard to the implementation of EH policies is quantified=
and this generates the evidence-base to support EH decision-making in=
countries of the WHO European Region.

=20

Ongoing methodological work:<=
/strong>

=20

=E2=80=A2 Final stages of the develop=
ment of methodologies for new exposure and health effect indicators that wi=
ll facilitate the efficient implementation of time-bound international=
commitments to protect children from the effects of environmental factors&=
nbsp;outlined at the 5th Ministerial Conference on Environment and Health (=
Parma, Italy, 2010).

=20

=E2=80=A2 Development of standardized=
data collection, processing and analysis methodologies for new surveillanc=
e programmes to assess exposure to environmental factors in children's faci=
lities and pre-natal exposures to developmental toxicants.

=20

=E2=80=A2 Development of a new IT pla=
tform and database for the European Environment and Health Information Syst=
em (ENHIS) to improve the presentation of indicator-based information on en=
vironmental exposures, health effects and EH oriented policy actions f=
or decision-making and EH professionals.

=20

=E2=80=A2 Assistance to selected Member St=
ates in the development and implementation of national EH information syste=
ms.

=20

Priority objectives beyond 2012:=
strong>

=20

=E2=80=A2 Methodological support to M=
ember States in the implementation of new EH data collection programmes for=
monitoring the implementation of international commitments to protect chil=
dren from EH risks.=E2=80=
=A2 Further development of ENHIS databases to enable storage and pooled ana=
lysis of raw EH data from Member States.=E2=80=A2 Further development of ENHIS indicators on exposure=
, to support burden of disease analysis.=E2=80=A2 Incorporation of EH inequality measures in ENHIS in=
dicators.

=20

New work to be undertaken in 2012:

=20

=E2=80=A2 Implementation of a new data base and IT platform for the Euro=
pean Environmental Health Information System (ENHIS), integrated into the I=
T infrastructure of the WHO Regional Office for Europe. =E2=80=A2 Upd=
ating data for the existing indicators of exposure and health effects in EN=
HIS. =E2=80=A2 Conducting new EH policy surveys in Member States to a=
ssess the EH policy situation in relation to new international commitments =
adopted at the 5th Ministerial Conference (Parma, 2010). =
=E2=80=A2 Pilot testing and implementation in ENHIS of new exposure and hea=
lth effect indicators for monitoring of the implementation of time-bound in=
ternational commitments to protect children from the effects of environment=
al factors. =E2=80=A2 Pilot testing of new indicators related to the =
impacts of climate change on health and the environment and incorporation o=
f these indicators into the European Environment and Health Information Sys=
tem (ENHIS). (The development of indicator methodologies had been conducted=
under a contract between the WHO Regional Office for Europe and the Europe=
an Commission/DG Sanco).

=20

Meetings planned for 2012:

=20

=E2=80=A2 Technical meeting on the implementation of new ENHIS indicator=
s for monitoring Parma conference commitments. =E2=80=A2 Meeting of t=
he European Environment and Health Task Force (a policy governing body of t=
he European EH Process) on monitoring of Parma commitments and the use of n=
ew proposed indicators.